Local Anesthetic-Related Methemoglobinemia During Cardiac Device Implantation; A Retrospective Registry: The LAMDA Study Kardiyak Cihaz İmplantasyonu Sırasında Lokal Anesteziye Bağlı Methemoglobinemi; Retrospektif Bir Kayıt: LAMDA Çalışması
Turk Kardiyoloji Dernegi Arsivi, cilt.53, sa.6, ss.423-427, 2025 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 53 Sayı: 6
- Basım Tarihi: 2025
- Doi Numarası: 10.5543/tkda.2025.62884
- Dergi Adı: Turk Kardiyoloji Dernegi Arsivi
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Central & Eastern European Academic Source (CEEAS), EMBASE, Directory of Open Access Journals, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.423-427
- Anahtar Kelimeler: Cardiac resynchronization therapy, implantable cardioverter-defibrillator, methemoglobin, methemoglobinemia, prilocaine
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: This study aimed to determine the frequency of methemoglobin development and identify associated factors in patients undergoing Implantable Cardioverter-Defibrillator (ICD) and Cardiac Resynchronization Therapy (CRT) procedures, with the local anesthetic prilocaine. Method: The data from 64 patients was analyzed. The patients’ methemoglobin levels before and after the procedure were measured and compared. The relationships between the results and factors such as creatinine, hemoglobin, body mass index (BMI) the incidence was not effected and the amount of prilocaine used were examined. Exclusion criteria included being aged under 18 years, pregnant, breastfeeding, presence of malignancy, undergoing chemotherapy, hemoglobin chain disorders, liver failure and renal failure (glomerular filtration rate (GFR) < 60 ml/min), chronic obstructive pulmonary disease, other hypoxic lung diseases and being a smoker. Results: Methemoglobin levels were significantly higher in the first hour after the procedure (P < 0.001). Oxygen saturation levels were significantly lower during the first hour post-procedure (P < 0.001). In the group with elevated methemoglobin levels after the procedure, creatinine levels were significantly higher (P < 0.001), while BMI (P < 0.001) and hemoglobin levels (P < 0.001) were significantly lower. No significant relationship was found with alanine transaminase (ALT) levels (P = 0.425). Conclusion: While significant methemoglobin elevation was observed following ICD/ CRT procedures with prilocaine, clinically significant methemoglobinemia cases are rare. A significant relationship was identified between methemoglobin elevation and BMI, hemoglobin and creatinine.